Failed Back Surgery Syndrome (FBSS)
Understanding persistent pain after spine surgery and treatment options
What is Failed Back Surgery Syndrome?
Failed back surgery syndrome means you have persistent or recurrent pain after spine surgery. This doesn't mean the surgery was necessarily a "failure"—many causes exist.
Common Causes of FBSS
Continued Pressure on Nerves
- • Residual stenosis not fully decompressed
- • Adjacent level degeneration
- • New herniation
- • Epidural scar tissue
Spinal Instability
- • Inadequate fusion
- • Pseudoarthrosis (non-fusion)
- • Adjacent segment degeneration
Muscular Factors
- • Deconditioning
- • Poor healing
- • Scar tissue
Other Factors
- • Complex regional pain syndrome
- • Central sensitization
- • Psychological factors
- • Non-surgical causes missed
Diagnosis
- •History of prior surgery
- •Current pain pattern
- •New imaging (MRI/CT)
- •Comparison to pre-op imaging
- •Provocative testing
Conservative Treatment
Success Rate: 40-60%
- • Physical therapy (often very helpful)
- • Pain management
- • Epidural steroid injections
- • Radiofrequency ablation
- • Psychology/pain management evaluation
When Revision Surgery is Considered
- •Identifiable cause on imaging
- •Conservative care trial first
- •Realistic expectations (outcomes lower than primary surgery)
- •Addressing specific cause
MIS Revision Options
MIS Revision Decompression
If residual stenosis or epidural scar
Success Rate: 70-80% (lower than primary)
Recovery: 4-6 weeks
Adjacent Level Surgery
If degeneration at adjacent level
Fusion or decompression as indicated
Success Rate: 75-85%
Revision Fusion or Stabilization
If pseudoarthrosis or instability
Success Rate: 75-80%
Recovery: 6-8 weeks
Questions About FBSS?
Our team specializes in revision spine surgery and complex cases. Contact us to discuss your specific situation.
Greenberg Spine
Minimally Invasive Spine Surgery